ICD-10-PCS Body Parts

Body Parts

Body parts are the fourth character in our ICD-10-PCS code in the Medical and Surgical Related Sections. You might remember that Character #2 was body system. Let's talk about the two real quick so we understand the difference between body parts and body systems.

Body System

The body system character 2 identifies the general anatomical region involved in the procedure. Remember, there are 31 body systems in ICD-10-PCS for the Medical and Surgical Section (character 0)

0

Central Nervous System

1

Peripheral Nervous System

2

Heart and Great Vessels

3

Upper Arteries

4

Lower Arteries

5

Upper veins

6

Lower Veins

7

Lymphatic and Hemic system

8

Eye

9

Ear, Nose, Sinus

B

Respiratory System

C

Mouth and Throat

D

Gastrointestinal System

F

Hepatobiliary System and Pancreas

G

Endocrine System

H

Skin and Breast

J

Subcutaneous Tissue and Fascia

K

Muscles

L

Tendons

M

Bursae and Ligaments

N

Head and Facial Bones

P

Upper Bones

Q

Lower Bones

R

Upper Joints

S

Lower Joints

T

Urinary System

U

Female Reproductive System

V

Male Reproductive System

W

Anatomic Region, General

X

Anatomical Region, Upper extremities

Y

Anatomic Regions, Lower Extremities

 

The body systems are unique to the Section - the 31 systems above are only for the Medical and Surgical Section. For example, in the Obstetrics section the only body system is 0 = Pregnancy. In the Administration section there is a Body System of E = Physiological Systems and Anatomical Regions.

Body Parts

Like Body Systems, body parts are unique to the section you are in - however they are always the 4th character in our ICD-10-PCS code. There are WAY more body parts then there were body systems. For example - here is just a very small sample of body parts for the Medical Surgical Section (0):

Body Part

Includes

1st Toe, Left 1st Toe, Right

Includes: Hallux

Abdomen Muscle, Left Abdomen Muscle, Right

Includes: External oblique muscle Internal oblique muscle Pyramidalis muscle Rectus abdominis muscle Transversus abdominis muscle

Abdominal Aorta

Includes: Inferior phrenic artery Lumbar artery Median sacral artery Middle suprarenal artery Ovarian artery Testicular artery

Abdominal Sympathetic Nerve

Includes: Abdominal aortic plexus Auerbach's (myenteric) plexus Celiac (solar) plexus Celiac ganglion Gastric plexus Hepatic plexus Inferior hypogastric plexus Inferior mesenteric ganglion Inferior mesenteric plexus Meissner's (submucous) plexus Myenteric (Auerbach's) plexus Pancreatic plexus Pelvic splanchnic nerve Renal plexus Solar (celiac) plexus Splenic plexus Submucous (Meissner's) plexus Superior hypogastric plexus Superior mesenteric ganglion Superior mesenteric plexus Suprarenal plexus

Abducens Nerve

Includes: Sixth cranial nerve

Accessory Nerve

Includes: Eleventh cranial nerve

Acoustic Nerve

Includes: Cochlear nerve Eighth cranial nerve Scarpa's (vestibular) ganglion Spiral ganglion Vestibular (Scarpa's) ganglion Vestibular nerve Vestibulocochlear nerve

Adenoids

Includes: Pharyngeal tonsil

Adrenal Gland Adrenal Gland, Left Adrenal Gland, Right Adrenal Glands, Bilateral

Includes: Suprarenal gland

Ampulla of Vater

Includes: Duodenal ampulla Hepatopancreatic ampulla

Anal Sphincter

Includes: External anal sphincter Internal anal sphincter

Ankle Bursa and Ligament, Left Ankle Bursa and Ligament, Right

Includes: Calcaneofibular ligament Deltoid ligament Ligament of the lateral malleolus Talofibular ligament

Ankle Joint, Left Ankle Joint, Right

Includes: Inferior tibiofibular joint Talocrural joint

Anterior Chamber, Left Anterior Chamber, Right

Includes: Aqueous humour

 

The left column explains what the body part name is and the right colum explains all the things that are covered under that body part. For example - the Abdominal Aorta body part includes the inferior phrenic artery, lumbar artery, median sacral artery, middle suprarenal artery, ovarian artery, and the testicular artery.

 True or False?

 True or False?

 

 

Body Parts

When we look up a procedure in the index in ICD-10-PCS, we know we always get the first three character of Section, Body System, and Root operation. We very often also get the fourth character - Body Part. For example - when I look up an appendectomy I get:

appendectomy.jpg

If it is a an excision then my first four characters are ODBJ and if it is a resection (meaning they took out the whole appendix) then I am at ODTJ. J is the fourth character on both of these - J must stand for appendix. When I go to the table to look this up (I will say mine is a resection) - I see this:

appendectomy2.jpg

 

You can see that appendix is already highlighted for me as I was given the first four characters in the index.

 

Within a specific Section and body system I have body part characters with the same meaning. In this case - all of the body part characters in the Gastrointestinal System (D) are consistent. Below you will see another code table for the Gastrointestinal system in the Medical and Surgical Section. This time my root operation is for Repair instead of resection

odq.jpg

 

You will note that the body part character for esophagus, upper is 1 on both of these - the stomach, pylorus is 7 on both of these - the appendix is J on both of these codes. These body part characters DO NOT carry over into other Body Systems however. For example - if I move out of the Gastrointestinal System and into the Upper veins you will see that the body part character of 1 now means Hemiazygos vein, the body part character of 7 now means Axillary Vein, right, and the body part character J does not exist.

051.jpg

 True or False?

 

Body Part Key

At the end of the pdf version of the ICD-10-PCS book you will find a body part key. This key tells you which body part you should use. For example

Accessory phrenic nerve

Use: Phrenic Nerve

Accessory spleen

Use: Spleen

Acetabulofemoral joint

Use: Hip Joint, Right Hip Joint, Left

Achilles tendon

Use: Lower Leg Tendon, Right Lower Leg Tendon, Left

Acromioclavicular ligament

Use: Shoulder Bursa and Ligament, Right Shoulder Bursa and Ligament, Left

Acromion (process)

Use: Scapula, Right Scapula, Left

Adductor brevis muscle

Use: Upper Leg Muscle, Right Upper Leg Muscle, Left

 

You can also access the Body Part Key here: http://www.tacomacc.edu/UserFiles/Servers/Server_6/File/him//him240/pcs/bodypartkey.pdf

 

Let's try it

Given this table - answer the questions below

odb.jpg

 What would your fourth character (body part) be?

 What would your fourth character (body part) be?

 What would your fourth character (body part) be?

Now - of course the operative report will not always be so clear - they may very well say calcaneus and you will not be able to find that in the body part column - you would have to look at the body part key and know that calcaneus codes to the body part talus or that the olecranon process codes to the ulna body part or that the gluteal vein codes to the hypogastric vein body part.

 True or False?

 

Body Part Coding Guidelines

The Body Part Guidelines are found under B4 in the Official ICD-10-PCS Coding Guidelines. They are all follows:

B4. Body Part

General guidelines

B4.1a

If a procedure is performed on a portion of a body part that does not have a separate body part value, code the body part value corresponding to the whole body part.

Example: A procedure performed on the alveolar process of the mandible is coded to the mandible body part.

B4.1b

If the prefix "peri" is combined with a body part to identify the site of the procedure, the procedure is coded to the body part named.

Example: A procedure site identified as perirenal is coded to the kidney body part.

Branches of body parts

B4.2

Where a specific branch of a body part does not have its own body part value in PCS, the body part is coded to the closest proximal branch that has a specific body part value.

Example: A procedure performed on the mandibular branch of the trigeminal nerve is coded to the trigeminal nerve body part value

Bilateral body part values

B4.3

Bilateral body part values are available for a limited number of body parts. If the identical procedure is performed on contralateral body parts, and a bilateral body part value exists for that body part, a single procedure is coded using the bilateral body part value. If no bilateral body part value exists, each procedure is coded separately using the appropriate body part value.

Example: The identical procedure performed on both fallopian tubes is coded once using the body part value Fallopian Tube, Bilateral. The identical procedure performed on both knee joints is coded twice using the body part values Knee Joint, Right and Knee Joint, Left.

Coronary arteries

B4.4

The coronary arteries are classified as a single body part that is further specified by number of sites treated and not by name or number of arteries. Separate body part values are used to specify the number of sites treated when the same procedure is performed on multiple sites in the coronary arteries.

Examples: Angioplasty of two distinct sites in the left anterior descending coronary artery with placement of two stents is coded as Dilation of Coronary Arteries, Two Sites, with Intraluminal Device.

Angioplasty of two distinct sites in the left anterior descending coronary artery, one with stent placed and one without, is coded separately as Dilation of Coronary Artery, One Site with Intraluminal Device, and Dilation of Coronary Artery, One Site with no device.

Tendons, ligaments, bursae and fascia near a joint

B4.5

Procedures performed on tendons, ligaments, bursae and fascia supporting a joint are coded to the body part in the respective body system that is the focus of the procedure. Procedures performed on joint structures themselves are coded to the body part in the joint body systems.

Example: Repair of the anterior cruciate ligament of the knee is coded to the knee bursae and ligament body part in the bursae and ligaments body system. Knee arthroscopy with shaving of articular cartilage is coded to the knee joint body part in the Lower Joints body system.

Skin, subcutaneous tissue and fascia overlying a joint

B4.6

If a procedure is performed on the skin, subcutaneous tissue or fascia overlying a joint, the procedure is coded to the following body part:

• Shoulder is coded to Upper Arm

• Elbow is coded to Lower Arm

• Wrist is coded to Lower Arm

• Hip is coded to Upper Leg

• Knee is coded to Lower Leg

• Ankle is coded to Foot

Fingers and toes

B4.7

If a body system does not contain a separate body part value for fingers, procedures performed on the fingers are coded to the body part value for the hand. If a body system does not contain a separate body part value for toes, procedures performed on the toes are coded to the body part value for the foot.

Example: Excision of finger muscle is coded to one of the hand muscle body part values in the Muscles body system.

 

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